Dear all I totally agree whatever you guys described about EHR software usage but as a Doctor and I have my own clinic I must share my thoughts with you.

I was not using EHR software in begging but as I feel me and my staff were investing our time on reports, prescriptions, patient details and blah blah .... One day one of my best friend Dr. Gupta suggested me to buy an EHR / EMR software, I start my searching on internet and I found an EHR system provider NORTEC SOFTWARE INC www.nortecehr.com, I contacted with them and I purchased a complete Electronic health record suit for my clinic.

Since that day I analyzed few things positive like .. I don't need to use my maximum staff, All records now on my finger tips, My patients are also happy with our services, Very user-friendly and most importantly I am saving a big part of my earning means better ROI.

At the end I must say there are a lot of advantages in EHR software utilizations.

From what I see, many issues come from the lack of communication between EMR vendors, labs, and medical devices. It'd be great if all the information was stored in the EMR but many times it's not and so patients information requires multiple clicks and signons to find out what is needed and requires manual input. It doesn't help that EMR vendors can charge an obscene amount to create connections to their solution to send/receive information to/from outside sources.

Mirth Connect seems to help save costs in many of these areas (I am a sales person for Mirth but Mirth Connect is available as a free open source solution).

I recently saw a chart on HealthIT.gov that demonstrated the more in-depth a clinic or hospital delves into an EHR system, the more satisfaction seems to go up. I wonder if maybe the high dissatisfaction that's being reported in blogs all over the internet are caused by lack of training or lack of full implementation?

The root cause of this problem is the business model of healthcare, and its protection from competition on cost and quality (unlike other industries). Until this is fixed, EHRs will be viewed as a cost center, and not as a strategic weapon to improve cost and quality.

For example, even in settings where EHRs work well and have high usability, doctors still click through Rx interaction warnings and ignore them because they take too much time to deal with. Why would they do this? Because they are not paid for quality of outcome, nor are they incentivized to minimize the net present value of the 'cost stream' of a given patient to the system.

So until these underlying incentives are changed at a systemic level, the never ending tug-of-war will continue between docs and IT in a largely zero-sum game. No other industry with real competition on cost and quality would take 20 years and find that only 5% of it's employees consistently use software (productively) at the point-of-service.

Tough to disagree with the participant comments. HealthCare IT serves two masters with widely differing agendas - administrators and caregivers. The administrative burden is to provide summary reports and billing coding for insurance and mandated government reporting. Caregivers need easy data input and timely and relevant synopsis and correlation of critical information based on inputs from various sources - for example, conflicting prescriptions from specialists treating the same patient but who are not familiar with what other regimens the patient may be under from other Doctors and caregivers. The point of the EHR was to have a single source of truth provide a global view of what is happening to a patient. Instead we have multiple systems that cannot communicate with one another - creating silos of information. This is what I am hoping the Affordable Health Care act addresses - but it will take time. WIth the Political element trying to destroy better healthcare for Americans it will take even more time. Currently we have "Health Care Systems" built from older IT building blocks and re-purposed for health. They then had to expand to include the regulatory environment, billing environment and somehow lost the plan to build an "ideal" practice UI for doctors and nurses. We need to get back to that and then use IT in the background to mate the caregiver interface with the backend billing and abstract the administrative overhead out of the way of the practice pieces. Ultimately a cloud based system based on universal rules and best practices is where we need to head. Don't see the need personally for coding methodologies and caregiver training to track my flu-shot to differ between Oregon and Alabama.

Meaningful engagement by physicians is indeed a huge problem. I work in an institution on an EHR implementation and mainenance team which consistently sees many MDs refusing to attend training and making ridiculous demands on how our small team should teach their larger collective team while continuing to fix "problems in the system" for them which often amount to not knowing how to use the system because they have refused to get training! And why is it there are so many "research" papers on physician opinions and a complete paucity of opinion by any other health-care provider? The same issue has reared its head numerous times in the past several decades with physician groups such as the AMA writing scope of practice papers on what other health-care providers can and can't do while their group consistently pushes the very work they are complaining is being stolen by other professions in a manner which is "outside their scope of practice" on those said other providers by pysicians because they don't want to do the work. (I am also a practicing Pharmacist.)Double-speak among MDs is common. Many meetings we have contain both the satements "the system didn't tell me I should..." or "the system didn't warn me about..." along with "I'm alert fatigued". You can't have it both ways! It is also not uncommon to have a discussion where "alert fatigue" is first cited followed not more than 5 minutes later by "can't the system give us warning about that?" Really!?!

I can't in good conscience let the government regulations or insurance companies off the hook though either. As mentioned in the article briefly, regulations on how to submit data, what the data has to say, all the wierd hoops you have to jump through to get a claim processed and even more importantly what boxes to check so it doesn't get denied are ludicrous at this point. There is definitely pressure from these stringent and often not well planned out requrements which make EHR endeavors that much more complicated.Let's be really honest here, not all this software is that crummy. Many products are quite useful and can be tailored to meet the needs of providers of all types with proper engagement. An iterative, agile methodolgy needs to be used in order to get the best results.Finally, let's once again look at some of these complaints in a truer light. I have looked at medical records from my personal experience as well as my family member's experiences in both the paper and electronic world. The mistakes made in physician documentation are unchanged in this small sample between both environments--statements of complaint which were not discussed inserted, wrong medication names (and I'm talking on the lines of Zantac versus Pepcid here which could never be a system suggestion error) and the list goes on. Also, we have not noticed a difference in wait times at the clinic to see the doctor or actual amount of time spent with a physician between the paper world of yore and the electronic world of today. These differences from a patient's perspective are far more important than the number of clicks to complete a note!

As InformationWeek Government readers were busy firming up their fiscal year 2015 budgets, we asked them to rate more than 30 IT initiatives in terms of importance and current leadership focus. No surprise, among more than 30 options, security is No. 1. After that, things get less predictable.